WASHINGTON (Reuters) - Treating severe pneumonia in
children at home with oral antibiotics works just as well as
treating them with intravenous drugs at a hospital as advised
by the World Health Organization, scientists said on Thursday.

Pneumonia is one of the world's leading child killers,
particularly in South Asia and sub-Saharan Africa.

The researchers said their findings in this study of 2,037
children ages 3 to 5 in Pakistan should prompt the U.N. health
agency to change its recommendations on treating severe
childhood pneumonia.

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The WHO advises that children with severe pneumonia be
referred to a hospital and treated with intravenous
antibiotics. But many sick children in developing nations are
unable to reach a hospital for such treatment, the researchers
said. And oral treatment at home is much cheaper, they added.

About 2 million of the 10 million deaths annually in
children under age 5 worldwide are caused by pneumonia -- an
inflammation of the lungs caused by an infection.

"It exceeds malaria, it certainly exceeds HIV and it
exceeds diarrheal diseases, too," Dr. Donald Thea of the Boston
University School of Public Health, one of the researchers,
said in a telephone interview.

The study involved children with severe pneumonia who
arrived at hospitals in seven locations in Pakistan. About half
were sent home to take an oral antibiotic, amoxicillin, in
syrup form. The others were treated intravenously in the
hospital with an equivalent antibiotic, ampicillin.

STUDY: HOME TREATMENT SAFE, EFFECTIVE

The treatment at home was just as safe and effective as the
hospital treatment, the study found. Of the five children who
died within 14 days of entering the study, one was treated at
home, with the other four among the hospitalized.

WHO guidelines call for children with pneumonia that is not
severe to be treated at home with oral antibiotics, but
hospitalization and intravenous antibiotics for severe cases.

The researchers said the WHO guidelines can be ineffective
in practice because many children with severe pneumonia in
developing countries who are referred to hospitals for
treatment never reach them because they have no means of
transportation or are too far away.

The researchers envision medicine distribution to children
with pneumonia by health-care workers in local communities.

Treatment with oral antibiotics also avoids the possibility
of infection that can occur with administering intravenous
drugs due to factors like unsterile needles, they added.

"Safe community-based treatment alternatives will
substantially increase the number of children who can receive
effective care" and save lives and money, the researchers wrote
in the Lancet medical journal.

In an commentary accompanying the study, Dr. Shams El
Arifeen of the International Centre for Diarrhoeal Disease
Research in Bangladesh and Dr. Abdullah Baqui of Johns Hopkins
University in Baltimore called the study "a milestone."

The findings should change the management of severe
pneumonia in children in developing countries, they added,
writing: "The potential impact here is enormous, particularly
for the many children with severe pneumonia who are referred to
hospitals but never reach them."

Thea said the findings and other data will be presented to
the WHO next month, with the hope of getting new treatment
recommendations in about nine months to a year.